HomeMy WebLinkAboutMiscellaneous - 63 WATER STREET 4/30/2018Date ..3.`. � S :.0 3
+ti TOWN OF NORTH ANDOVER
o
p PERMIT FOR PLUMBING
This certifies that ..(�- bP.U.-'!� � �....... .. • • . • .. • ........ •
has Oermission to perform ....9:���A"'.° e . ...................
plumbing in the buildings of . J�! i ,"! �' ..A 5� O C`
3 �v��� s�
at...60. I North%Andover, Mass.
Fee. .?....Lie. No. � bd �.. .. .P22 i . IM !1'<< ~-. .
PLUMBING INSPECTOR
Check # R ( I `(
5549
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
Mass. Date Permit# `Fr
s4
Building Location iy iG�l �Or"' � Owner's Name In
New ❑ Renovation R__1_ Replacement
FEATURES
,of Occupancy
Plans Submitted Yes ❑ No qEt—
Installing Company NamefR/1n%�f (rGUU i� lL c4 ! LG,f7-
a --�� ld,/n Check one: Certificate
Address , . /�%5 %moi iV ��_E i oma/ % ,PEE7– Corporation
. /fE ��S ,—O,F'1� /aj/,? /� /C ' ❑` Partnership
Business Telephone_ ❑ Firm/Co.
Name of Licensed Plumber_ FiC"/��(J.f' (6.1,
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142.
Yes No ❑
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity ❑ --Bond ❑
OWNERS INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement.
Check one:
Signal &e of Owner or Owner's Anent Owner ❑ .. Agent ❑
I hereby certify that all of the details and.information I have submitted (or entered) in above application are true and accurate to
the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will
be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
.-Signature01 Licensee mer
Title Type of License: Mastw)6 Journeyman ❑
y7-
City/Town License Number
APPROVED OFFICE USE ONLY)
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SUB-BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
Installing Company NamefR/1n%�f (rGUU i� lL c4 ! LG,f7-
a --�� ld,/n Check one: Certificate
Address , . /�%5 %moi iV ��_E i oma/ % ,PEE7– Corporation
. /fE ��S ,—O,F'1� /aj/,? /� /C ' ❑` Partnership
Business Telephone_ ❑ Firm/Co.
Name of Licensed Plumber_ FiC"/��(J.f' (6.1,
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142.
Yes No ❑
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity ❑ --Bond ❑
OWNERS INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement.
Check one:
Signal &e of Owner or Owner's Anent Owner ❑ .. Agent ❑
I hereby certify that all of the details and.information I have submitted (or entered) in above application are true and accurate to
the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will
be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
.-Signature01 Licensee mer
Title Type of License: Mastw)6 Journeyman ❑
y7-
City/Town License Number
APPROVED OFFICE USE ONLY)
Machine Shop'Village Neighborhood Consemat on Disif ct Cornrnission
1600 Osgood Street North Andover, MA 01843
xcation For EXCLUSION From Certificate to :meter
Certain alterations are excludedfrom review by the Machine ,Shop Village Neighborhood
Conservation District Commission in accordance with the Bylaw. Applicants for exempt,prajectr
must fill out the form below and submit to the Commission Chairperson (contact info below).
Date:
FA
Contact Name & Address: _
UV,A 4!CT -I-
1 -1 '�; (Ak ri tc
-1-1Ag
Project Address: 6 4 & Q 'l `+ 54—
Project Description (attach additional pages, if needed):
Exclusion From Kiev ew Requested For:
CI
1. interior Alterations
existing conditions including materials,
design and dimensions.
®
2. Storm windows and doors, screen
windows and doors.
❑ 9. Replacement of existing substitute
doors, substitute siding or substitute
0
3. Removal, replacement or installation of
windows with new materials that are
gutters and downspouts.
substantially similar to the existing
condition.
U
4. Removal, replacement or installation of
window and door shutters.
® 10. Replacement of original fabric
windows or doors with substitute
0
5. Accessory. buildings of less than 100
windows or doors that maintain the
square feet of floor area.
architectural integrity with. respect to
form, fit and function of the original
0
G. Removal of substitute siding.
windows or doors.
7. Alterations not visible from a public
Q 11. Reconstruction, substantially similar in
way.
exterior design, of a building, damaged or
8. Ordinary maintenance and repair of
destroyed by fire, storm or other disaster,
provided such reconstruction is begun
architectural features that match the
within one year thereafter.
MSV NCDC Page 1 Current Chair: Liz Fennessy, 77 Elm Street, lizettafennessy -yahoo.com, 978688-29.15
Machine Shop Village Neighborhood Conservation District Comniission
1600 Osgood Street North Andover, MA 01845
fication. For EXCLUSION From Certificate : to.
For Items 9,10 or 11) provide the following documentation:
Photos1drawings of existing doors, windows or siding, as applicable
—DescriptionlCatalog Cuts of proposed materials to be used for doors, windows or siding
Plan and elevation of reconstruction for Rem I.1
Determination:
This project as determined to be
exempt
Q not exempt
front review by the Machine Shop Village Neighborhood Conservation District Commission. Projects
that are not exempt must complete the Application fior Certificate to Alter, available from the Building
Department and be reviewed by the Commission.
Determination made by
I
M
Neighborhood Conservation District Commission
Date
MSV NCDC Page 2 Current Chair: Liz Fennessy, 77 Elm Street, lizettafennessy(a,yahoo.coni. 978-688-2915